36 Ona MHCC and OD Paper DLSU

Uncovering Opportunities for Open data in Community Health practices: Imperatives for building stakeholder capacities in the Philippines Sherwin Ona, Ma. Beth Concepcion, Michelle Ching and Sarah Angeles De La Salle University, Republic of the Philippines Corresponding author: Sherwin E. Ona, PhD ([email protected]) Abstract: The move towards openness and innovation has resulted in a mix of opportunities and challenges. The founding of the Open Government Partnership (OGP) in 2011 underscored the importance of adopting transparency and accountability mechanisms by using open government techniques. Furthermore, this sparked a global trend of re-examining the role of data and how the opening of data sets can result to better governance. However, recent experiences show that merely opening data sets is just an initial step. One of the major challenges is on how to bridge the supply of open data to that of demand. For local governments, bridging supply with the demand for open data mean that there is a need to ensure its efficacy and relevance in addressing local reQuirements. In the Philippines, open government initiatives are often linked to the agenda of good governance and inclusive growth. In particular, the Millennium Development Goals (MDGs) has functioned as one of the yardsticks for attaining inclusive growth. As for its commitment to the OGP, the Philippines has embarked on several initiatives aimed at making government more transparent and governance more participative with local government units (LGUs) being considered as the next frontier. However, in 2012, the government has conceded that the MDG target on maternal mortality (MDG-5) will not be met. Local studies point to the inadequate management of community health data as one of the reasons why there is difficulty in monitoring maternal health cases thus contributing to the failure of achieving MDG-5. With this recognition, we see an opportunity to link open government initiatives in local governments to MDG targets in community health. Through the development the human capacities of LGUs to use their local data sets to enhance their ability to manage their health information and at the same time addressing their commitment to the national objectives on good governance. In our paper, we used the results of our previous study on the community practices in maternal health and child care (MHCC) in selected municipalities. Administered by the local government units (LGUs), these practices show the different opportunities on how to use health data sets. With the intent of adding to our previous findings, we conducted an analysis of stakeholder requirements. Moreover, our study was able to surface themes pertaining to the data-information management practices through the use of critical incidence technique. These themes were examined and were presented as possible factors necessary to develop an open government capacity building program for community health practitioners in LGUs. We also examined 2 LGU websites using content analysis to determine the possible venues for open data. Keywords: Open data, information technology, data sets, community health, participation and local governance. I. Introduction As a public health concern, maternal health and child care (MHCC) continues to be a priority in the Philippines. In fact during the past two decades, MHCC concerns have figured prominently in the national health programs. With the intention of attaining its MDG-5 targets by 2015, the government’s universal health agenda (2011-2016) underscored the importance of MHCC by increasing the allocation of financial resources. This move by the national government signalled its desire to improve the situation on the ground by building more community health centers, hiring more health professionals, and increasing medical supplies. However, despite these significant developments, the Philippine maternal mortality rate (MMR) rose to 221 per 100,000 live births in 2011 from 162 in 2009 (DOH, 2012). Another related (and equally alarming) trend shows a 65% increase in teenage pregnancy from 2000-2010 (NSO, 2012). This reality suggests that the Philippines will definitely miss the prescribed MDG-5 target of 52 per 100,000 live births. Furthermore, it leads us to Question why such failure exists despite of the government’s commitment to improve its MMR. Given the significant investments in national and community health programs, these recurring problems seem to suggest that a holistic-systematic approach might be needed. This approach must take into account all the facets that surround MHCC especially in the local communities (known locally as “barangay”). It is also interesting to note that aside from the usual problems on supplies, literacy, and other socio-economic related issues, prevailing literature also point to the inability to manage information-data of MHCC and that it continues to hamper the efficient delivery of services. This is due to the inadequate organizational and human capacity which is further aggravated by the lack of information management tools and skills. In this paper, we focused on the need to develop the local capacities in managing MHCC data. In particular, we examined the needs and requirements of MHCC stakeholders. Anchoring our paper on the previous studies of MHCC practices in local communities, we again posit that open government techniQues and learning content can be used to address information-data related concerns. By ensuring the access to relevant data and its visualization, we further argue that open data techniQues can support decision-making tasks in LGUs and mobilize community stakeholders. Moreover, making such efforts is consistent with the desire of the local government units (LGUs) for achieve its seal of good governance goals on transparency, accountability and participation. II. Prevailing literature and the background of the Study MHCC programs are considered as one of the basic health services in the Philippines. Categorized as a primary healthcare need, MHCC initiatives have seen a steady increase in budget allocation thus resulting to significant gains. However, current community-barangay health practices are often characterized as nationally-driven (top-down), centralized, and resource-oriented practices (Angeles, 2014) (La Vicente et al, 2012). These practices discourages the active participation of the community and results to dependence on the national government. Another concern is on the occurrence of information gaps which causes the inability of health officials to accurately determine health reQuirements. Angeles (2014) further notes that these practices exhibited passive participation and the monologic communication mode of participation which often leads to poor health practices such as labor intensive service delivery, untimely health services and reactive intervention to health issues. On a related issue, a 2007 review and assessment of the Philippine health information system points to the existence of “core problems” of the health and management information system. The study enumerated the following as: “a) information gaps; b) underutilization of data; c) excessive generation of data; d) poor reliability and validity of data; e) inadequate skills in information management; f) lack of cost effectiveness in health management” (PHIN, 2007); The PHIN study also cited the previous work of Jayasuriya (1994) in which the author pointed to major information gaps due to “inappropriateness of available information regarding needs and that such information was not used in the different management levels”. The study also highlighted the high cost of maintaining routine information systems. (p. 28). In addition, Huntington et al (2011) further reiterated that data collection in community health remains to be a challenge, citing it as a laborious and expensive process. In particular, the study specifically points to the difficulty of harmonizing information from different data sources. Hence, numerous studies have reiterated the findings of the PHIN assessment, citing the need to improve the health information system (HIS) to enable effective monitoring of MHCC cases (Huntington et al, 2011) (La Vicente et al, 2013). To further understand these information-data related practices and the possible open data implications, the study of Ona et al (2014) examined community-level MH practices in selected rural communities. This study observes that that data management practices are consistent with the findings of Huntington et al (2011) and the PHIN report (2007). However, the study also underscored the existence of practices that tend to utilize data both for decision-making and transaction management. These practices are the mapping of MHCC cases using spot maps and the use of log books to consolidate MH data. Ona et al (2014) argues that these activities the use of visualization and physical data sets in community health planning thus opening opportunities for the use of OG-OD techniQues. The study of Ching et al (2014) further captures these artefacts and argued that indeed these are opportunities for open data to explore. Open Data: Challenges and opportunities Open data is an emerging practice that opens public information and data for possible re-use (Bauer and Kaltenbock, 2011). As a movement, it advocates for transparency and accountability (O’Hara, 2012; O‘Rain et al 2012; Jansen, 2011). Current studies show the potentials of open data in healthcare. Curcin et al (2012) points to the need to establish data registries

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